In response to AHRQ's request for research projects to make health care safer in ambulatory care settings and long term care facilities (RFA-HS-15-002), the goal of this proposed project is to make primary care safer by generating new evidence on strategies to improve two high priority safety problems-overuse of low-value services and safer use of health information technology (HIT). Overuse of low-value services which may cause serious patient harms is common in the primary care setting, and research on interventions to reduce overuse is limited. Evidence is also limited on safe HIT practices in primary care. Moreover, HIT has been cited as a means to both improve the measurement of and reduce overuse, yet few studies have explored these potentials. The proposed project seeks to examine these potentials through developing electronic clinical quality measures for overuse, integrating two successful models for increasing delivery of recommended preventive services and safe HIT use, and testing the impact of this integrated model on overuse of preventive services in primary care practices in a two year group randomized controlled trial. The project will be conducted in the Primary Care Practices Research Network (PPRNet), an AHRQ-sponsored Center for Primary Care Practice- Based Research and Learning. A mixed methods approach, combining both quantitative and qualitative analyses, will be used to assess the impact of the integrated framework on overuse. The findings from this project will lead to new evidence on strategies for using HIT safely and effectively in the primary care setting to reduce overuse and improve patient safety. The results will be applicable to the tens of thousands of primary care providers who have adopted EHRs in the United States.